| NPI | 1255673604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 60840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103028) |
| 207R00000X Internal Medicine (Licence: TN 60840) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2026-06-16 |